Initial management strategies for the most frequent intoxications in emergency services in Brazil: a narrative review

• DOI: https://doi.org/10.22533/at.ed.15952025240414

• Palavras-chave: Intoxication; Substance Use Disorders; Emergency Medical Services; Drug Overdose; Clinical Epidemiology.

• Keywords: Intoxication; Substance Use Disorders; Emergency Medical Services; Drug Overdose; Clinical Epidemiology.

• Abstract:

  Introduction: Poisoning is a pathological condition resulting from exposure to toxic substances. In the case of acute poisoning, exposure occurs within 24 hours, requiring rapid intervention. Objective: To identify the most frequent intoxications in emergency departments in Brazil, indicating the appropriate course of action. Method: This is a narrative literature review. It included 25 articles published between 1991 and 2025, as well as the use of epidemiological sources. The data was collected using the PubMed, SciELO, LILACS and CAPES Periodicals Portal databases. Results: There was a predominance of drug poisoning, followed by drugs of abuse and household products. In Brazil, benzodiazepines are the most frequently involved psychotropic drugs. The antidote, flumazenil, is controversial due to its association with serious adverse events. Other gastrointestinal decontamination measures are not recommended. Alcohol is the main etiologic agent of intoxication by drugs of abuse. The management of ethyl intoxication should begin with the systematic ABCDE approach. Laboratory tests play a crucial role in the management of poisoning by caustics, although their correlation with the severity of the lesions is limited. The treatment of poisoning by caustic products should be directed according to the extent of the lesions and the mode of exposure. Conclusion: Exogenous poisoning represents a significant demand on emergency services in Brazil. Given the magnitude of the problem, it is essential to invest in the continuous training of health professionals.